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However, new treatments, particularly those that include the use of new implants, may lead to increased costs to both hospitals and payers.
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The caprine (goat) femoral condyle and trochlear defect models have been used successfully for evaluation of new implants for treatment of partial thickness and osteochondral defects (Fig. 1) (Klein et al. 2009; Jurgens et al. 2013; Nukavarapu & Dorcemus 2013).
Subsequently, computational models are in use to refine and indeed develop designs of new implants for the spine.
Efforts to obtain stability using less invasive techniques have lead to the advent of new implants and constructs.
The development of new implants requires detailed biomechanical studies.
In recent years, the minimally invasive surgical techniques have led to a widespread use of many new implants [ 5, 6]it has been shown that they can reduce operative complications and postoperative morbidity.
Implant designers are now compelled to use these data in the design and testing of new implant systems.
In patients who would like a reposition augmentation mammaplasty after breast implant removal but reject the use of a new implant after implant removal because of capsular contracture, autoaugmentation mammaplasty using a deepithelialized inferior-based flap of subcutaneous and breast tissue is an option.
It corrects ptosis and increases the projection and apparent volume of the breast when mastopexy is planned without use of a new implant.
This together with continuous education and training in how to use new implants should be an integral part of the process of a more cautious market introduction.
As there is a correlation between excessive early migration and continuous migration of the implant and a greater risk of implant failure (Ryd et al. 1995), RSA should be used to evaluate new implants or design modifications to provide an early indication of long-term fixation (Kärrholm 2012, Malchau 2000, Ryd 1986, 1992).
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